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article imageOp-Ed: Homoeopaths scramble into damage control mode

By Bart B. Van Bockstaele     Jan 24, 2011 in Health
After the recent airing on the CBC of a Marketplace episode that exposed homoeopathy as a potentially dangerous non-treatment, CP24's Wylde on Health aired an episode defending homoeopathy: Homeopathy, does it work?
“Homoeopathy, does it work? That’s the question we try to answer for you tonight through some of the best science and reasonable theories that exist to date.”, says host Bryce Wylde in his introduction.
There are two people in the studio with him, David Brulé and Cees Baas, and one is hanging on the phone at the other side of the ocean, in London, England. The one on the phone is Dr. Peter Fisher, physician to the Queen and Director of the Royal London Homeopathic Hospital.
Bryce Wylde starts with an interesting question to Peter Fisher: “Why is it that you’d be qualified to answer this question this evening on my show tonight: What is homoeopathy, and why does it work?
Peter Fisher: Why am I qualified? Well, because I’ve practised homoeopathy for a very long time, I am editor of an international journal called homoeopathy, which is the only journal that is in Pubmed which is the official US National Institutes of Health recognised journal and, as you mentioned, I am homoeopath to the Queen.
In the words of Edzard Ernst, “homoeopaths tend to be economical with the truth”, and indeed, Peter Fisher got it wrong. “Homeopathy” is certainly not the only journal in Pubmed, but it is also not the only homoeopathic journal in the database.
We live in a culture where the opinions of celebrities (illiterate and/or idiot or not) are more valued than those of people who actually know what they are talking about, so it comes as no surprise that Fisher is advertising his relationship with the British Royals, unimpressive though this relationship may be from a scientific point of view. He did omit to mention his position at the Royal London Homeopathic Hospital, a rather more impressive credential.
Bryce starts the conversation by asking Peter Fisher to explain what homoeopathy is, to lift some of the confusion with herbal medicine and naturopathy, and he suggests talking about the Law of Similars and hormesis.
Fisher explains that the Law of Similars is about treating like with like, and about giving the body information on the nature of the problem in order to stimulate it to heal itself. Although he avoids the magical part of homoeopathy, his is actually a surprisingly good reply in comparison to what is usually given, and well-worth listening to.
Wait a minute. Magic? Yes. Homoeopathy is based –in part– on the idea of the Vital Force, a my(s)thical force that is supposed to be in all of us. According to Samuel Hahnemann, the man who created homoeopathy, his highly diluted products serve to coax the Vital Force (which is thought to be powerful but not very intelligent) into attacking the disease.
Part of homoeopathy is also the concept of miasms, a type of fundamental cause of disease, of which the psora (itch) is the most important one. This magical thinking is also why some people call homoeopathy a religion or a cult. As a result, reading what homoeopaths are being "taught" is not unlike returning to the Dark Ages.
The conversation then switches to hormesis. Peter Fisher explains what is meant by it, and he does so rather nicely, although he gives an example that has nothing to do with homoeopathy, and nothing even with human medicine.
He carefully avoids linking it explicitly to homoeopathy, even though he usually does exactly that. This may have something to do with the fact that he has been ridiculed for doing so, since except perhaps for very low dilutions, hormesis cannot explain homoeopathy.
I couldn’t help but notice that Peter Fisher says nothing about the confusion of homoeopathy with herbalism and naturopathy. While he is talking, we are shown clips from Boiron commercials. Boiron is the world’s largest manufacturer of homoeopathic products.
Then follows a most remarkable conversation. Even though it is a typical example of the meaningless blather homoeopaths are used to produce, Bryce Wylde does manage to plant the stereotypical homoeopathic claim that homoeopathy doesn’t play the game of “merely suppressing the symptoms” whereas medicine does:
Bryce Wylde: My wife is at home right now with my two children. Both of them have been very ill. You know, throwing up with this 24 hour stomach flu, they’ve been complaining of stomach pain, vomiting, they’re very nauseous, you move them, they throw up, you leave them be, they seem to be OK. What would you recommend for that, as a grounded example of how we would apply homoeopathy? What questions might you ask me as relates to their state, and how would you then prescribe a remedy?
Cees Baas: Gosh!
Bryce Wylde: We don’t have enough time in the show, right?
Cees Baas: Hahahah! I’ll send you my invoice after the show. What you want to know is a number of characteristics about the symptoms and very often also about the person. For example, if one of your children is more of a chubby, sweaty child then that child might need a different remedy for this stomach flu than your child who is very thin and very precise.
Bryce Wylde: Why do we think? Because wouldn’t it only matter as relates to what given presentation in the moment, like the vomiting, don’t we just want to suppress the symptoms, the vomiting?
Cees Baas: Not in homoeopathy. In homoeopathy, usually, we treat long-standing complaints. It’s not so easy to suppress them. I mean, we’ve tried in conventional medicine for centuries.
Bryce Wylde: Right. But certainly, these symptoms of nausea, and you know vomiting, and you know dizziness, they must play a role and a very important role in the decision of what medicine to use?
Cees Baas: Oh yah, absolutely, and you can also make remedies where some of the most frequently prescribed remedies for this kind of complaint is put together and we have a number of examples here on the table, but usually in chronical cases it’s more complicated.
I can imagine a few reasons for this pathetic display, and I am not talking about the invoice. Yes, I know it is surprising, but I do understand it was meant as joke. I actually got that one. I will be insufferably pleased with myself now, for at least a whole second (for the fans: this is a Star Trek reference).
Among others, it may be that Cees Baas doesn’t know about the 24-hour stomach flu. Bryce Wylde and Cees Baas may have very different views of what homoeopathy is all about. That would not be surprising. An application of the “personalization” claim?
Also funny is that Cees Baas says that it is possible to put some of the most frequently prescribed product together in one product. This seems homoeopathic heresy given that Samuel Hahnemann advocated prescribing a single product, but he is right, this is frequently done in modern homoeopathy. Given the evidence-free nature of homoeopathic practice, one should wonder how homoeopaths figure out which products are prescribed most frequently?
Given that this was meant as a demonstration of homoeopathic treat-the-whole-person holistic diagnosis, it seemed clear from this that this is merely a synonym for “making it up as you go along”.
Bryce now turns to David Brulé and asks him about “the market trends”. David Brulé says that homoeopathy is growing, that around 20% of the population in India is using it and that it is increasing at least 5% to 10%.
Bryce Wylde replies that this is because the science is becoming more and more abundant. That seems questionable. There is indeed more and more science with respect to homoeopathy, but he neglects to mention that most of the new science is only confirming what we already thought we knew on the basis of older science, namely that homoeopathy is a placebo.
It is now Peter Fisher’s turn to answer a question.
Bryce Wylde: This is really the question, the topic of today. It boils down to this. I am going to ask you to really if you can, quote a few science papers, we got a couple of minutes before the break, but is homoeopathy more effective than placebo?
Peter Fisher: Yes, clearly it is. In a number of areas, for instance in allergies, in children with upper respiratory tract infections, in rheumatology, children with diarrhoea -a very big problem in underdeveloped countries- a number of areas, it’s clearly been demonstrated that it is different from placebo.
And one of the interesting things is we now have biological models, that means animals or cell models that you can do in a test tube that show effects of these very high dilutions, because there is a problem, you know, with some of the dilutions. If you use a 30C dilution, and it got sulphur written on the label, actually all the sulphur has been diluted out. That is a problem, there is no question, that is a big scientific problem, but it’s one that is starting to crack open.
Another series of claims. The 30C dilution is indeed a big problem, but not one we are interested in at the moment, given that the subject is "Does it work?", and not "How does it work?". And the scientific papers, where are they? Melted away? Evaporated? Maybe they have become illegible because of coffee stains? (Hahnemann claimed earlier that coffee was a major cause of disease, instead of the psora).
Bryce Wylde: Should homoeopaths be claiming that homoeopathy can cure cancer, or perhaps even act as a prophylaxis for disease in the same way as vaccines would?
Peter Fisher: No. We’ve had a lot of trouble with that in the UK.
He goes on to say that “some poorly trained” homoeopaths were advising people who went to Africa, not to use antimalarial drugs but to use homoeopathics instead, with the result that people were coming back ill and that they could die.
The situation is not that simple, however. It seems that the problems in the UK are not yet over: BBC article.
Homoeopathic cancer treatment (Toronto School of Homeopathy)
Homoeopathic cancer treatment (Toronto School of Homeopathy)
Fisher also says that his hospital has cancer treatments, but in a complementary fashion, not to cure cancer, but to improve life, and reduce the side effects of cancer treatments, such as hot flashes in women.
Bryce Wylde closes the segment by saying that homoeopathy has a scope, that the science is there. Strangely enough, he doesn’t mention the science, probably because it is demonstrating that homoeopathy is a placebo.
Bryce Wylde: Coming up next, we’ll present more evidence supporting homoeopathic medicine […]
More evidence? That doesn’t seem quite correct, does it? The programme has now been running for 10 minutes, and except for some unfounded claims, we are still waiting for the very first piece of evidence.
After the commercials, Bryce Wylde presents Jim Dunsdon, the president of the Transitional Council of the College of Homeopaths of Ontario, a committee that is preparing the regulations that homoeopaths will have to follow if and when the profession becomes regulated in Ontario. This is certainly an interesting subject, but in light of the subject of this episode, “Does homoeopathy work?” it is mere filler material, a time-waster, and I prefer to skip it.
As usual when alternologists appear on television, there is a small warehouse of boxes and bottles on the table with assorted types of pills and elixirs that they are peddling to their customers, and Bryce Wylde asks about them.
David Brulé picks up a box he says is aimed at children’s colic. He says that homoeopathic products are “pretty inherently safe”. He is -of course- correct, in saying that. There is nothing (or hardly anything) in them, except for fillers such as water, alcohol or sugar. He also says that Health Canada “regulates a lot of these products, anything that is on the market in Canada”. That is partly true.
Homoeopathics are actually exempt from having to provide evidence that they work. So, what exactly is the value of Health Canada’s regulations? It is essentially limited to guaranteeing that the products are safe, not that they work as claimed. Consequently, homoeopathics should be seen as a luxury food item, nothing more.
Bryce Wylde asks a very important question: “Does safe mean effective?” Once again, we are given a useless non-answer.
David Brulé: “Well, safety is one component. Effectiveness and efficacy are another component, so safe doesn’t necessarily mean effective, but we can get to efficacy and effectiveness in terms of the research a little later on, I guess.”
Wylde then goes on to say that although safe doesn’t mean effective, science has a very hard time to prove placebo in animals and children. According to him, the science community well acknowledges that it works for children, and mothers have a very very high response for efficacy when it comes to giving this to their children.
Cees Baas: Yah, but sadly, placebo does happen in animals and children. It does. But there’s remedies here that have been through decent clinical studies with children. A lot of the things here on the table do actually really work.
Very interesting, except that they aren’t being named and that no evidence is provided.
After the commercials, Bryce Wylde starts of by saying something that is quite true, namely that there is no such thing as 100% proof in any type of medicine. That’s left up to mathematicians and other professionals, he says, and he continues that there are only varying degrees of evidence in medicine.
True enough, and that is also the case for any and all science. At least in principle, all science is tentative and open to refutation and change. Contrary to popular opinion, science is not a body of knowledge, but rather a method to acquire that knowledge in a way that protects us from fooling ourselves, and that is quite likely the very reason that homoeopaths and other alternologists are so vehemently opposed to it, even when they claim otherwise.
Bryce now presents a medical doctor who -according to him- is opposed to the practice of homoeopathy and who says that homoeopathy does not work, and who joins the programme on the phone from Ottawa: Dr. Yoni Freedhoff.
I can’t help but wondering why they had to invite someone from Ottawa. Surely, it isn’t that hard to find doctors in Toronto who are critical of homoeopathy, which would have made it possible to have them on the set in the studio? Maybe, just maybe, it was because it is easier to shut up someone on the phone than someone in the studio?
Yoni Freedhoff: I don’t remember saying at any point homoeopathy didn’t work. I do believe that it certainly yet has to be proven that it does. There is a distinction there, and I think it is an important one for viewers because I think some people have the belief that Western medicine doctors look down their noses at things they don’t understand, and I don’t think that’s true, I think that what many of us require is publicly verifiable evidence.
We need to understand not only the science behind something, but also have publicly reproducible, verifiable evidence that it does in fact do what it is purported to do, and I think that to date, homoeopathy doesn’t fall into that camp.
Bryce Wylde: […]It’s important to know that there seems to be compelling evidence to suggest that it requires a lot more research. So, I appreciate that. So, is it perhaps false logic to suggest that because homoeopathy is often seen as implausible it is therefore impossible?
Yoni Freedhoff: I think that it is difficult for anybody to say that something is impossible, but I think in terms of homoeopathy for it to be in fact a real and valid scientific discipline, it would have to be creating its own new laws of physics [protest can be heard in the background]. That doesn’t mean there can’t be new laws of physics, but it certainly would put the onus on homoeopathy to prove that in fact they are there and that they do exist.
Cees Baas: I have a background in physics, but that’s not the point. Where I totally agree and that’s the most important point, yes, homoeopathy is not at the point where we are certain what we can do and under which circumstances our efforts work best. I totally agree with Dr. Freedhoff there. We don’t need new laws of physics, because we’ve shown, we’ve demonstrated that homoeopathy is not placebo, it’s not nonsense, but exactly how we can optimise our procedures, that is what we are working on.
Bryce Wylde: how important is it that every single thing in medicine, providing it is safe and seemingly effective in the research, is explainable as it relates to the mechanism of action?
Dr. Freedhoff: I think that we don’t always understand the mechanisms of actions of drugs. You know, there are lots of anti-depression medications and others that we know work and we have the basic mechanism as to what they’re doing in the brain, but why they translate into helping people, we don’t understand. But I do take issue with one of the statements by Dr. Baas before in the sense that there really hasn’t yet been conclusive evidence that homoeopathic medicines do work, in a sense of retaining molecular memory and more importantly, in terms of efficacy.
At this point, a Boiron commercial is shown again. Quite clever since that is of a nature to prevent people from concentrating on what Dr. Freedhoff is saying, hence distracting them from a rather important exposé.
There’s been three meta-analyses that I am aware of, and perhaps there’s more, [Cees Baas in the background: ‘There’s been five’] Of the three I am aware of, two were done by the same gentleman, a Dr. Linde, and his first in 1997 did demonstrate that perhaps there was more benefit than one would expect from placebo for homoeopathy, but he was criticised, because the studies he included in his analysis were weak, and so he repeated it with more rigorous testing and then he admitted that his original study’s results were most likely quite overestimated, and then finally, in 2005 a fairly famous paper published in The Lancet, a Dr. Shang also went ahead and looked at the same literature and before he set out to look at it, he set the criteria by which which trials were rigorous enough to include, and he concluded at the end that in fact the findings of homoeopathic trials to date, are consistent with the placebo effect. [Bryce Wylde is trying to stop the doc from talking. Consequently, a small part is inaudible]. So, I don’t think that homoeopathy has been proven at this point, certainly not conclusively, that there is anything going on there, and I would argue that it has been fairly conclusively shown that to date, placebo and homoeopathy are equivalent.
David Brulé: I guess there is a lot of critique on the Shang study as well, there’s been a couple of studies that have come out that have shown biases in that study and that their conclusions cannot be verified and what not, so you know I think it is a work in progress, you are absolutely right, there is no conclusive evidence that’s saying that homoeopathy is not a placebo, but we see a lot of compelling evidence in efficacy trials, in clinical trials that are pointing in that direction so I understand that you don’t think we should jump in and be using homoeopathy in a conventional setting, but given the compelling evidence and the safety record of homoeopathy it should be permitted while the research catches up.
Again, repeated claims of compelling evidence, but no evidence is produced.
Bryce Wylde: […]placebo indeed does have a positive response, and that’s probably a whole other show[…]
In one sense, Bryce is right to mention this, since many people confuse “placebo” with “no effect”, but it also suggests that he is grasping at straws, that he is saying that even if homoeopathy is a mere placebo, it is something valuable. In a way, he is right, however we should point out that placebos delivered through a non-magical ritual are a lot cheaper than homoeopathy.
Bryce Wylde continues: “Up next, more evidence that supports homoeopathy…”
More evidence? The programme has now been running for slightly less than 25 minutes, and we still have to be shown the very first piece of evidence.
After the break, Bryce Wylde says: Welcome back, we’re talking more about homoeopathy. The question today is, does it work? Here’s something to consider: scepticism is healthy, close-mindedness is not, and there is a lot of compelling evidence to support homoeopathy and certainly more of its research.
Wylde is correct in saying that scepticism is healthy and close-mindedness is not. He does forget to add that gullibility is not particularly healthy either, and gullible is precisely what one has to be to believe in homoeopathy.
The conversation is now sidetracked by talking about a study on homoeopathy and AD/HD for which evidence is claimed but not shown.
Bryce Wylde: […]You’re holding a number of papers, it’s just another show to go into all the evidence that really does exist out there[…]
Three phone calls were accepted at the end of the programme. The first caller asked if homoeopathy is safe for pregnant women. Cees Baas replies that she should stay away from D2/D3 solutions (D2/D3 is the same as 2X/3X), because there is still some active ingredient left and that this may not be safe, but that higher dilutions are safe. David Brulé comments that its better to be under the care of a homoeopath/naturopath/regular doctor who is familiar with these products. Bryce Wylde agrees.
The second caller asks about homoeopathy for hepatitis B and C. Cees Baas says that these are difficult diseases to treat, that they have many cases in the community where treatment has been successful but that there are many long-term complications and that you want to keep your internist involved.
This is a typical alternologist statement. Baas does not say that homoeopathy was a successful treatment but he does make the standard “complementary” or “integrative” move of advising to keep a genuine medical specialist (internist) involved. A beautiful move, since it gives the alternologist the opportunity to claim success when the patient gets better, and to blame the medical specialist when it goes wrong. This is a nice win/win proposition for the alternologist, a lose/lose proposition for the doctor.
Bryce Wylde jumps in to say that homoeopathy does not work prophylactically, that there is no homoeopathic equivalent for Twinrix or a Hepatitis abc shot.
He then asks Cees Baas if there is any treatment for diseases that are genetically related.
Cees Baas replies that “we don’t treat the genetic background, we treat the complaints, and we can be very successful at that, but I have to warn you again, that there is always a medical reality to these things. You want to make sure that your homoeopathic prescriber understands that. You mentioned the vaccinations, you have to be careful.
Bryce Wylde adds that they are ancillary.
The last questioner asks about homoeopathy for asthma and allergy. David Brulé claims that it can be very effective, that it is a constitutional care situation, that there is no one remedy for asthma but that looking at the “whole person” and treating constitutionally is your best bet.
Bryce Wylde finishes by saying that “a very staunch sceptic” wrote to him that “the best way to stay healthy is not to get sick” and that he replied that this was probably the smartest thing he ever read from him. Once again, no source is mentioned.
He then advises people to consider the homoeopathic product Oscillococcinum because the flu rates are up in Canada.
You may want to hold off on that for a while, and consider the flu shot instead.
Having seen this entire episode several times, looking for evidence I could have missed, I have to admit that the setup was quite clever. There were lots of time wasters where nothing of substance was said, punctuated by repeated suggestions that evidence had been shown and that more would follow. Since people tend to forget most of what is said in a programme within minutes to hours, it is highly likely that most viewers will only remember the claim that evidence was given, and forget that this was not so.
Nevertheless, there were some moments when I almost pitied Bryce Wylde, when he was unable to coax Yoni Freedhoff into saying what he wanted, and when Cees Baas had moments of honesty.
It left me with the impression that Cees Baas may not believe all that much in homoeopathy, but that he merely defends it because placebos are deemed to work better when the person prescribing them sounds confident that they do indeed work.
It should be noted that only three pieces of evidence, in the form of studies, were mentioned in the entire programme, and that was done by Yoni Freedhoff, the doctor who was called in as a “hostile witness”. The four homoeopaths in the programme, failed to name a single piece of evidence -credible or not- in support of their claims.
Homoeopaths are used to talk one-on-one, adapting to their customer, telling her/him what he/she wants to hear. Homoeopaths are essentially practicing cold reading, the same technique used by psychics to fool their customers into thinking that they do indeed have psychic powers, i.e. they are making it up as they go along, and cleverly call it “personalized medicine, or holistic medicine”.
This opinion article was written by an independent writer. The opinions and views expressed herein are those of the author and are not necessarily intended to reflect those of DigitalJournal.com
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